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https://www.readbyqxmd.com/read/28644260/intravenous-alteplase-for-acute-stroke-and-pulmonary-embolism-in-a-patient-with-recent-abdominoplasty
#1
Michael E Christiansen, Gyanendra Kumar, Raman C Mahabir, Richard A Helmers, Bernard R Bendok, Cumara B O'Carroll
INTRODUCTION: Major surgery in the past 14 days is a relative contraindication to treatment of acute stroke with intravenous (IV) alteplase. The 2016 American Heart Association/American Stroke Association scientific statement discussing inclusion and exclusion criteria for alteplase in acute stroke allows for provider judgment citing a lack of evidence to support surgery as an absolute contraindication. CASE REPORT: A 59-year-old woman presented with acute left hemiparesis, dysarthria, and acute respiratory failure...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28643745/adjuvant-hypofractionated-radiation-in-carcinoma-breast-photon-versus-electron-comparison-of-treatment-outcome
#2
G Prameela Chelakkot, Rahul Ravind, K Sruthi, Namrata Chigurupati, Sanketh Kotne, Raghavendra Holla, Ram Madhavan, M Dinesh
BACKGROUND: Breast cancer tissue is sensitive to hypofractionation. This is an analysis of patients treated with hypofractionated protocols since 2009, at our tertiary cancer center. METHODS: Details of breast cancer patients treated with adjuvant hypofractionated external beam radiation therapy (EBRT) from January 2009 to December 2014 were retrieved and analyzed. RESULTS: One thousand seven hundred and eighty patients received adjuvant EBRT during this period...
April 2017: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28642733/a-case-of-pulmonary-carcinoid-tumor-with-a-superimposed-aspergilloma-presenting-as-a-covert-ectopic-adrenocorticotropic-hormone-syndrome
#3
Kyoung Jin Kim, Ji Hee Yu, Nan Hee Kim, Young Hye Kim, Young Sik Kim, Ji A Seo
Ectopic adrenocorticotropic hormone (ACTH) syndrome is a challenging diagnosis only responsible for approximately 10% of Cushing syndrome cases. It has been associated with a variety of benign and malignant tumors including a carcinoid tumor accompanied by aspergilloma in our case that was significantly difficult to be detected. We report a patient over 70 years old with uncontrolled hypertension and hypokalemia presenting with generalized edema. Laboratory results revealed ACTH-dependent Cushing syndrome, but imaging studies did not show any discrete lesions secreting ACTH...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28641751/fetal-imaging-and-therapy-for-cdh-current-status
#4
Titilayo Oluyomi-Obi, Tim Van Mieghem, Greg Ryan
In congenital diaphragmatic hernia (CDH), herniation of the abdominal organs into the fetal chest causes pulmonary hypoplasia and pulmonary hypertension, the main causes of neonatal mortality. As antenatal ultrasound screening improves, the risk of postnatal death can now be better predicted, allowing for the identification of fetuses that might most benefit from a prenatal intervention. Fetoscopic tracheal occlusion is being evaluated in a large international randomized controlled trial. We present the antenatal imaging approaches that can help identify fetuses that might benefit from antenatal therapy, and review the evolution of fetal surgery for CDH to date...
June 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28640655/usual-interstitial-pneumonia-can-be-detected-in-transbronchial-biopsies-using-machine-learning
#5
Daniel G Pankratz, Yoonha Choi, Urooj Imtiaz, Grażyna M Fedorowicz, Jessica D Anderson, Thomas V Colby, Jeffrey L Myers, David A Lynch, Kevin K Brown, Kevin R Flaherty, Mark P Steele, Steve D Groshong, Ganesh Raghu, Neil M Barth, P Sean Walsh, Jing Huang, Giulia C Kennedy, Fernando J Martinez
RATIONALE: Usual interstitial pneumonia (UIP) is the histopathologic hallmark of idiopathic pulmonary fibrosis. While UIP can be detected by high-resolution computed tomography (HRCT) of the chest, HRCT results are frequently inconclusive, and pathology from transbronchial biopsy (TBB) has poor sensitivity. Surgical lung biopsy (SLB) may be necessary for a definitive diagnosis. OBJECTIVES: To develop a genomic classifier in tissue obtained by TBB that distinguishes UIP from non-UIP, trained against central pathology as the reference standard...
June 22, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28639114/imaging-guided-chest-biopsies-techniques-and-clinical-results
#6
REVIEW
Michele Anzidei, Andrea Porfiri, Fabrizio Andrani, Michele Di Martino, Luca Saba, Carlo Catalano, Mario Bezzi
BACKGROUND: This article aims to comprehensively describe indications, contraindications, technical aspects, diagnostic accuracy and complications of percutaneous lung biopsy. METHODS: Imaging-guided biopsy currently represents one of the predominant methods for obtaining tissue specimens in patients with lung nodules; in many cases treatment protocols are based on histological information; thus, biopsy is frequently performed, when technically feasible, or in case other techniques (such as bronchoscopy with lavage) are inconclusive...
June 21, 2017: Insights Into Imaging
https://www.readbyqxmd.com/read/28638618/swyer-james-macleod-syndrome-a-rare-diagnosis-presented-through-two-adult-patients
#7
Sumit Mehra, Thilini Basnayake, Henrik Falhammar, Subash Heraganahally, Suryakant Tripathi
Swyer-James-MacLeod syndrome (SJMS) is a rare syndrome of acute obliterative bronchiolitis following an early childhood infective insult to the lungs. This causes arrest of alveolarization, affecting lung development with hypoplasia of the ipsilateral pulmonary artery and results in a characteristic radiological pattern, such as a unilateral hyperlucent lung with expiratory air-trapping and pruned-tree appearance on pulmonary angiogram. The clinical presentation is either recurrent chest infections, exertional dyspnoea or it may be an incidental finding...
September 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28637046/the-preoperative-composite-physiologic-index-may-predict-mortality-in-lung-cancer-patients-with-combined-pulmonary-fibrosis-and-emphysema
#8
Fumika Ueno, Yoshiaki Kitaguchi, Takayuki Shiina, Shiho Asaka, Kentaro Miura, Masanori Yasuo, Yosuke Wada, Akihiko Yoshizawa, Masayuki Hanaoka
BACKGROUND: It remains unclear whether the preoperative pulmonary function parameters and prognostic indices that are indicative of nutritional and immunological status are associated with prognosis in lung cancer patients with combined pulmonary fibrosis and emphysema (CPFE) who have undergone surgery. OBJECTIVE: The aim of this study is to identify prognostic determinants in these patients. METHODS: The medical records of all patients with lung cancer associated with CPFE who had undergone surgery at Shinshu University Hospital were retrospectively reviewed to obtain clinical data, including the results of preoperative pulmonary function tests and laboratory examinations, chest high-resolution computed tomography (HRCT), and survival...
June 22, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28635204/esophago-pulmonary-fistula-manifesting-as-recurrent-pneumonias-and-migrating-mediastinal-calcifications
#9
Jadd Kebbe, Sai Yendamuri, Charles Roche, Kassem Harris, Samjot Singh Dhillon
A 43-year old man presented with recurrent pneumonias, episodes of hemoptysis and an enlarging right lower lobe mass. A clear diagnosis was not previously established in spite of multiple radiological evaluations and biopsies. Meticulous review of his CT imaging showed that he had subcarinal calcification on his prior CT scans, which had decreased in size and now multiple new small areas of calcifications were seen in the right lower lobe lesion. An esophago-pulmonary fistula due to migration of mediastinal calcifications was suspected which was identified on careful review of the CT chest and confirmed by esophagogastroduodenoscopy...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28634559/malignant-pleural-mesothelioma-with-marked-lymphatic-involvement-a-report-of-two-autopsy-cases
#10
Reiko Ideguchi, Kazuto Ashizawa, Saori Akashi, Michiko Shindo, Kazunori Minami, Toshio Fukuda, Junji Irie, Minoru Fukuda, Masataka Uetani
We herein report two cases of malignant pleural mesothelioma with marked lymphangiosis. The patients included a 68-year-old man and a 67-year-old man who both had a history of exposure to asbestos. Computed tomography (CT) on admission showed pleural effusion with pleural thickening. In both cases, a histopathological examination of the pleura confirmed the diagnosis of epithelioid malignant mesothelioma. They received chemotherapy, but the treatment was only palliative. The chest CT assessments during admission revealed marked pleural effusion and mediastinal lymphadenopathy...
2017: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/28633709/primary-pulmonary-actinomycosis-a-retrospective-analysis-of-145-cases-in-mainland-china
#11
M Zhang, X-Y Zhang, Y-B Chen
OBJECTIVE: To improve our understanding of pulmonary actinomycosis. METHODS: A retrospective analysis of 145 cases in mainland China was conducted. RESULTS: The male:female ratio was 2.7:1. Mean age at diagnosis was 48 years (± 12). Main symptoms were cough (87.6%), expectoration (40%), blood-stained sputum (37.2%), fever (26.9%), chest pain (24.8%) and haemoptysis (16.6%). Eighty-eight (60.7%) patients had no underlying disease. Only five patients received a correct initial diagnosis; 60 patients were misdiagnosed with lung cancer, followed by pulmonary tuberculosis (TB) and lung abscess...
July 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28633707/qualitative-analysis-of-biological-tuberculosis-samples-by-an-electronic-nose-based-artificial-neural-network
#12
E I Mohamed, M A Mohamed, M H Moustafa, S M Abdel-Mageed, A M Moro, A I Baess, S M El-Kholy
OBJECTIVE: To apply an e-nose system for monitoring headspace volatiles in biological samples from Egyptian patients with active pulmonary tuberculosis (TB) and healthy controls (HCs) and compare them with standard sputum analysis. DESIGN: The study population comprised 260 (140 males, 120 females) newly diagnosed TB patients and 240 (120 males, 120 females) HCs matched by age and socio-economic level admitted to hospitals specialising in chest diseases in Alexandria, Behera, Giza and Damietta Governorates, Egypt...
July 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28633335/pulmonary-tb-varying-radiological-presentations-in-individuals-with-hiv-in-soweto-south-africa
#13
Jesne Kistan, Fatima Laher, Kennedy Otwombe, Ravindre Panchia, Nohemie Mawaka, Limakatso Lebina, Andreas Diacon, Bavesh Kana, Neil Martinson
Background: HIV-uninfected individuals with pulmonary TB (PTB) commonly present with radiological features of upper lobe cavitatory disease. In contrast, individuals with HIV and PTB may present differently. This study compared radiological features of individuals with laboratory-confirmed PTB by HIV status from the largest study in South Africa. Methods: We conducted a cross-sectional analysis of adults recruited between 2012 and 2015 with laboratory-confirmed PTB in Soweto, South Africa...
March 1, 2017: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28632761/experience-improves-the-performance-of-endobronchial-ultrasound-guided-transbronchial-biopsy-for-peripheral-pulmonary-lesions-a-learning-curve-at-a-medical-centre
#14
Chun-Ta Huang, Sheng-Yuan Ruan, Yi-Ju Tsai, Chao-Chi Ho, Chong-Jen Yu
BACKGROUND: Endobronchial ultrasound(EBUS)-guided transbronchial biopsy(TBB) is the preferred diagnostic tool for peripheral pulmonary lesions(PPLs) and mastering this procedure is an important task in the training of chest physicians. Little has been published about the learning experience of physicians with this technique, particularly at an institutional level. We aimed to establish a learning curve for EBUS-guided TBB for PPLs at a medical center. METHODS: Between 2008 and 2015, consecutive patients with PPLs referred for EBUS-guided TBB at National Taiwan University Hospital were enrolled...
2017: PloS One
https://www.readbyqxmd.com/read/28631156/diagnosis-of-secondary-pulmonary-lymphangiectasia-in-congenital-heart-disease-a-novel-role-for-chest-ultrasound-and-prognostic-implications
#15
Christopher Z Lam, Tanmay Anant Bhamare, Tamadhir Gazzaz, David Manson, Tilman Humpl, Mike Seed
BACKGROUND: Secondary pulmonary lymphangiectasia is a complication of congenital heart disease that results from chronic pulmonary venous obstruction. OBJECTIVES: We aimed to evaluate the performance of chest ultrasound (US) in diagnosing secondary pulmonary lymphangiectasia and to review the clinical course of children with secondary pulmonary lymphangiectasia. MATERIALS AND METHODS: Chest US was performed on 26 children with hypoplastic left heart syndrome, total anomalous pulmonary venous connection or cor triatriatum in a prospective observational study...
June 19, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28630794/a-case-of-presumed-tuberculosis-uveitis-with-occlusive-vasculitis-from-an-endemic-region
#16
Berna Başarır, Yalçın Karaküçük, Çiğdem Altan, Banu Şatana, Bulut Ocak, Aslı İnal
In this report, we present a case with presumed unilateral tuberculosis uveitis from an endemic region. A 23-year-old male presented with decreased vision in his left eye for 15 days. Visual acuities were 1.0 in his right eye and 0.3 in his left eye. Ophthalmologic examination was normal for the right eye. Slit-lamp examination revealed 2+ cells in the vitreous without anterior chamber reaction in his left eye. Fundus examination revealed occlusive vasculitis and granuloma. His history revealed that he had a respiratory infection with fever 3 months ago while visiting his native country, Rwanda, and was treated with non-specific antibiotic therapy...
June 2017: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/28629919/comparing-pulmonary-nodule-location-during-electromagnetic-bronchoscopy-with-predicted-location-based-on-two-virtual-airway-maps-at-different-phases-of-respiration
#17
Brian S Furukawa, Nicholas J Pastis, Nichole T Tanner, Alexander Chen, Gerard A Silvestri
BACKGROUND: Electromagnetic navigational bronchoscopy (ENB) is guided-bronchoscopy to pulmonary nodules (PN) which relies on a pre-procedural chest CT to create a 3-dimensional (3-D) virtual airway map. The CT is traditionally done at a full inspiratory breath hold (INSP) but the procedure is performed while the patient tidal breaths, where lung volumes are closer to functional residual capacity. Movement of a PN from INSP to expiration (EXP) has been shown to average 17.6 mm. Therefore, the hypothesis of this study is that pre-procedural virtual maps built off a CT closer to physiological lung volumes during bronchoscopy may better represent the actual 3-D location of a PN...
June 16, 2017: Chest
https://www.readbyqxmd.com/read/28629872/sevoflurane-relieves-lung-function-deterioration-after-cardiopulmonary-bypass
#18
Adam L Balogh, Ferenc Peták, Gergely H Fodor, Roberta Sudy, Barna Babik
OBJECTIVE: To investigate sevoflurane's potential to alleviate the detrimental pulmonary changes after cardiopulmonary bypass (CPB). DESIGN: Prospective, randomized clinical investigation. SETTING: University hospital. PARTICIPANTS: One hundred ninety patients undergoing elective cardiac surgery. INTERVENTIONS: Ninety-nine patients under intravenous anesthesia were administered 1 minimal alveolar concentration of sevoflurane for 5 minutes after being weaned from CPB (group SEV); intravenous anesthesia was maintained in the other 91 patients (group CTRL)...
February 24, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28629554/emphysema-quantification-and-lung-volumetry-in-chest-x-ray-equivalent-ultralow-dose-ct-intra-individual-comparison-with-standard-dose-ct
#19
Michael Messerli, Thorsten Ottilinger, René Warschkow, Sebastian Leschka, Hatem Alkadhi, Simon Wildermuth, Ralf W Bauer
OBJECTIVES: To determine whether ultralow dose chest CT with tin filtration can be used for emphysema quantification and lung volumetry and to assess differences in emphysema measurements and lung volume between standard dose and ultralow dose CT scans using advanced modeled iterative reconstruction (ADMIRE). METHODS: 84 consecutive patients from a prospective, IRB-approved single-center study were included and underwent clinically indicated standard dose chest CT (1...
June 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28628646/the-impact-of-glycemic-status-on-radiological-manifestations-of-pulmonary-tuberculosis-in-diabetic-patients
#20
Li-Kuo Huang, Hsueh-Han Wang, Yi-Chun Lai, Shi-Chuan Chang
SETTING: Diabetes mellitus (DM) may increase risk of pulmonary tuberculosis (PTB) and influence its radiological manifestations. OBJECTIVE: To evaluate the impact of glycemic status on radiological findings of PTB in diabetic patients. METHODS: Between January 2010 and December 2015, chest radiographs (CXRs) in consecutive 214 DM patients with culture-proved PTB and 123 available thoracic computed tomography (CT) scans were enrolled. An equal number of non-DM patients with similar demographics was included as the control group...
2017: PloS One
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